Shading sign of endometrioma

Case contributed by Prashant Gupta
Diagnosis almost certain

Presentation

Menstrual disturbance for one month.

Patient Data

Age: 50 years
Gender: Female

Note: This case has been tagged as "legacy" as it no longer meets image preparation and/or other case publication guidelines.

mri
Axial
T1
Axial
T2
Axial
T2
Sagittal
T2
Axial T1
fat sat
T1 fat
sat
T1
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Info

T1 hyperintense cyst in the right ovary. T1 fat saturation showing that the hyperintensity is not fat but hemorrhage. T2 shading sign. In the sagittal plane, there is a large left ovarian cyst as well. A tortuous tubular hyperintensity is seen in the right adnexa, likely a hematosalpinx.

Case Discussion

Shading sign is the magnetic resonance (MR) imaging finding of T2 shortening in an adnexal cyst that is hyperintense on T1-weighted images. It is helpful as a distinguishing feature of endometriotic cysts (endometriomas) on MR imaging.

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